Duloxetine dosage

CYP450 2D6 inhibitors (e.g., paroxetine, fluoxetine, duloxetine) can raise clozapine levels, but dosage adjustment usually not necessary... 

Cigarette smoking induces CYP4501A2 and may reduce plasma levels of duloxetine, but dosage modifications are not recommended for smokers... 

Inhibitors of CYP450 2D6, such as paroxetine, fluoxetine, and quinidine, may increase plasma levels of duloxetine and require a dosage reduction of duloxetine... 

Despite these negatives, duloxetine would be the first drug approved by the FDA for treating SUI. Based on studies conducted to date, a dosage regimen of 40 to 80 mg/day (in 1 or 2 doses) appears reasonable. 

The increases in tolterodine levels were not considered to be clinically relevant, and no routine dosage adjustment of tolterodine dosage was considered necessary when given with duloxetine. Consider also Urinary antimuscarinics Tolterodine + Fluoxetine , p.l290. 

Serotonin-norepinephrine reuptake inhibitors (SNRIs) (e.g. duloxetine, venlafaxine and desvenlafax-ine) inhibit the reuptake of both serotonin and norepinephrine and are referred to as dual inhibitors or selective serotonin norepinephrine inhibitors . The SNRIs lack of anticholinergic side effects results in a distinct advantage over traditional TCAs [13,77,78]. For example, duloxetine is a potent, balanced inhibitor of serotonin and norepinephrine reuptake [79]. Venlafaxine inhibits serotonin reuptake at lower dosages and inhibits both serotonin and norepinephrine reuptake at higher dosages [70,80]. 

Russell et al. demonstrated that duloxetine at dosages of 60 mg/day and 120 mg/day for up to 6 months was safe and effective in the treatment of fibromyalgia with or without major depressive disorder [3]. They also provided more robust assessment efficacy of duloxetine in fibromyalgia than most previous published studies that were only for 3 months duration. 

Psychiatric Binge eating has been attributed to duloxetine 90 mg/day in a 37-year-old woman the behavior resolved when the dosage was reduced to 60 mg/day... 

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